Provider Demographics
NPI:1942204847
Name:WELCH, JAMES STEVEN (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STEVEN
Last Name:WELCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 PECAN DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5774
Mailing Address - Country:US
Mailing Address - Phone:817-341-2520
Mailing Address - Fax:
Practice Address - Street 1:1115 PECAN DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5775
Practice Address - Country:US
Practice Address - Phone:817-458-3254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7941207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178450601Medicaid
TX2631895OtherAETNA PROVIDER NUMBER
TX398702601Medicaid
TX8EK529OtherBCBS
TX178450602Medicaid
TXP01398054OtherRAILROAD MEDICARE
TX0098GVOtherBLUE CROSS PROVIDER NUMBE
TX178450604Medicaid
TX178450602Medicaid